INTRAMUSCULAR ADMINISTRATION OF KETOROLAC VERSUS TRAMADOL POST OPERATIVELY IN MINOR ORAL SURGERY

Dr Anand Mangalgi; Dr. Deepika Mallasure; Dr Kundan Shah; Dr. Sangmesh Sajjanshetty; Dr. Supriya Patil; Dr. Sudha Halkai

Volume : VII, Issue : XII, December - 2018

INTRAMUSCULAR ADMINISTRATION OF KETOROLAC VERSUS TRAMADOL POST OPERATIVELY IN MINOR ORAL SURGERY

Dr Anand Mangalgi, Dr. Deepika Mallasure, Dr Kundan Shah, Dr. Sangmesh Sajjanshetty, Dr. Supriya Patil, Dr. Sudha Halkai

Abstract :

Background & Objectives

Surgical removal of impacted mandibular third molars is a procedure frequently carried out on an out–patient basis and analgesia is necessarily a balance between achieving adequate pain relief while causing minimum side effects. Pain is a common complaint often occurring with inflammatory processes after a tooth extraction. Postoperative pain following surgical removal of a

mandibular third molar is validated, well documented and highly sensitive model to assess therapeutic relief of moderate to severe pain. The ultimate goal of oral health care providers is not only to restore function, but also to relive pain. Analgesics are commonly prescribed to alleviate pain induced by the inflammation. Patients with post – operative pain are currently treated with various drugs in two main categories:

i) Non – steroidal anti – inflammatory drugs (NSAIDS)

ii) Narcotic analgesics.

Ketorolac is a potent NSAID that avoids the problems associated with narcotic analgesics [potential for addiction, drug tolerance and respiratory depression while still achieving a narcotic like efficacy. Tramadol is a synthetic analogue of codeine and causes minimal respiratory depression, few gastrointestinal effects and has less potential for opioid like dependence. The objective of this study was to compare the analgesic efficacy of post – operative intramuscular ketorolac versus tramadol in preventing post–operative pain after mandibular third molar surgery.

Patients & Method

Forty patients under the age group of 16 – 40 yrs with asymptomatic impacted mandibular third molars were randomly assigned into one of the two groups (20 in each group), and underwent third molar surgery under local anesthesia. Group I received IM ketorolac 30mg and Group II received tramadol 50 mg post – operatively. The difference in post – operative pain was assessed by five primary end points : pain intensity measured every hourly by a I0 cm visual analogue scale for 12 hours, onset of analgesia, duration of action, total no of analgesics consumed, and patient‘s global assessment.

Result

Throughout the 12 hours investigation period, patients reported significantly lower pain intensity scores, longer duration of action, lesser post – operative analgesics consumption and better global assessment in ketorolac when compared to tramadol group. Patients in the ketorolac group significantly performed better than the tramadol group in terms of all parameters except onset of analgesia. All the drug related complications were mild and did not require any intervention.

Conclusion

The results of the present study shows that post–operative intramuscular ketorolac 30 mg is more effective than tramadol 50 mg for post–operative pain following third molar surgery.